【摘要】 目的总结胰岛细胞瘤所致癫痫发作及认知功能障碍的临床特点、影像学表现、脑电图及病理特征。方法分析1例表现为癫痫发作及认知功能障碍的胰岛细胞瘤患者的临床资料,并复习相关文献报道。结果患者49岁,女性,主要表现为多种类型的癫痫发作及认知功能障碍。发作时测血糖均<1.7mmol/L;头MRI检查示胼胝体压部病灶。脑电图检查示左颞枕区中波幅尖波,双侧各程可见长短程高波幅慢波。胸部增强CT检查示胰腺头颈部交界区富血供肿瘤。行肿瘤切除术后病理学诊断为胰岛细胞瘤。术后患者未再出现低血糖及抽搐发作,遗留记忆力减退。结论临床应高度警惕伴有低血糖的顽固性不典型的癫痫患者是否有胰岛细胞瘤的可能,以尽早诊断及治疗,改善预后。更多还原

【Abstract】 Objective To summarize the clinical,imaging,electroencephalogram and pathological characteristics of insulinoma which presented with seizures and disturbances of cognition.Methods A case of insulinoma presenting with seizures and disturbances of cognition was reported and relevant literatures were reviewed.Results The patient was a Chinese woman aged 49.She presented with various kinds of seizures and continuous disturbances of cognition.When she suffered from a seizure,the blood glucose was always less than 1.7 mmol/L.The MRI of brain showed a lesion in the splenium of the corpus callosum.EEG presented with sharp waves in areas of the left temporal-occipital lobe and generalized slow waves.A pancreatic head and neck tumor with rich blood supply was showed by CT scan.After the operation,the pathology showed an insulinoma.The patient never has a seizure after operation but is left with a sequelae of disturbances of cognition.Conclusions We should highly pay attention to a patients with atypical refractory seizures and hypoglycemia to find whether he has,insulinoma then the best treatment can be adopted to avoid the sequelae.更多还原